Neuro - Auditory System Flashcards

1
Q

What are the 3 parts of the ear?

A

Outer
Middle
Inner

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2
Q

Where is the ear organ located?

A

In the petrous part of the temporal bone - the hardest bone in the body

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3
Q

What makes up the outer ear

A

The pinna and the ear canal

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4
Q

What are the functions of the outer ear

A

Capture sound and focus it on the tympanic membrane
Amplify some frequencies by resonance in the canal
Protect the ear from external threats

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5
Q

How does the outer ear protect from external threats

A

Hairs in the canal

Wax provides physical barrier and also pH of wax kills things coming into the ear

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6
Q

What is the function of the middle ear

A

Amplification of sound

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7
Q

What makes up the middle ear

A

Tympanic membrane

3 ossicles with their associated muscles, tendons and ligaments

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8
Q

How does the middle ear amplify sound

A

Focuses vibrations from large surface area onto the smaller oval window to increase pressure
Uses leverage from the incus-stapes joint to increase the force on the oval window

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9
Q

What makes up the inner ear

A

Cochlea

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10
Q

What is the function of the inner ear

A

transduce vibrations into nervous impulses and also provide a frequency and intensity analysis of sound

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11
Q

What are the 3 cochlea compartments

A

Scala vestibuli
Scala media
Scala tympani

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12
Q

What is perilymph

A

Fluid found in the scala vestibuli and tympani which is high in sodium

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13
Q

What is endolymph

A

Fluid found in the scala media high in potassium

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14
Q

Where is the organ of Corti located

A

In the basilar membrane of the scala media

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15
Q

How is the Basilar membrane organised

A

Tonotopically - there s a narrow and tight base with a wide and loose apex

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16
Q

What frequencies cause vibrations in the base of the Basilar membrane

A

High frequency

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17
Q

What frequencies cause vibrations in the apex of the basilar membrane

A

Low frequency

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18
Q

What makes up the organ of Corti

A

Thousands of hair cells (both IHC and OHC)

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19
Q

What is the tectorial membrane

A

Located above the hair cells and allow deflection of hair cells to cause cell depolarisation

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20
Q

What cells are in constant contact with the organ of Corti

A

OHC

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21
Q

What nerves do IHC mainly carry

A

95% afferent fibres of the auditory nerve

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22
Q

What nerves do OHC mainly carry

A

95% efferent fibres of the auditory nerve

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23
Q

What is the function of afferent auditory nerves

A

Transduction of sound into nerve impulses

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24
Q

What is the function of efferent auditory nerves

A

Modulation of the sensitivity of the response (active amplifying of the OHC)

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25
What are the hairs of hair cells called
Stereocilia
26
What does stereocilia deflection lead to
Deflection towards the longest cilium causes the opening of K channels and thus depolarisation
27
Explain the process of transduction
Vibrations cause the IHC to contact the tectorial membrane and thus their stereo cilia deflect and K channels are opened. There is influx of K into the cell and thus depolarisation, leading to the opening of voltage gated calcium channels. These channels open and therefore calcium causes the exocytosis of glutamate out of the fair cells and thus a nervous response in propagated through the afferents of the auditory nerve
28
Describe the pathway of auditory information from the cochlea to the cerebral hemisphere
Spiral ganglions from the cochlea extend to the cochlear nucleus. Auditory information then reaches the superior olive and crosses contralaterally (some fibres stay ipsilateral). Fibres then travel to the inferior colliculus in the brainstem and then to the medial geniculate body in the thalamus. Finally fibres reach the auditory cortex in the cerebral hemisphere.
29
What is the need for tonotopic arrangement of hearing
If we can't discriminate different frequencies then we cannot discriminate or interpret speech
30
What is frequency
Cycles per second, perceived tone | Pitch
31
What is amplitude
Sound pressure, subjective attribute correlated with physical strength (loudness)
32
What is the range of frequency for hearing
20-20,000 Hz
33
What is active amplifying
OHC can contract or elongate to alter whether or not IHC will come into contact with the tectorial membrane - this means that we can hear sounds that are too soft and our ears aren't damaged from sounds that are too loud
34
What is the normal range of amplitude
0-120dB
35
What type of scale is the decibel scale
Log scale
36
What is the need for a log scale for decibels
Allows us to compress the scale on a graph - reflects the fact that many physiological processes are non linear
37
How does hearing alter with age
Hearing acuity decreases with age, particularly higher frequencies - medium and low can be affected with the progression of a hearing loss
38
What are the 3 questions in a hearing assessment?
Is there hearing loss?§ If so - of what degree? Of what type?
39
What procedures can we use to test hearing
``` Tuning fork Audiometry Central processing assessment Tympanometry Otoacoustic emission Electrocohcleography Evoked potentials ```
40
What is a tuning fork used for
Establish probable presence or absence of a hearing loss with a significant conductive component, therefore provide early and general information if audiometry is not available
41
What is a Weber test
Vibrate fork to see if patent hears on both sides the same
42
What is a Rinne test
Directly stimulate the bone as endolymph vibrates to see if there is a problem with the middle/ inner ear
43
What is pure tone audiometry (PTA)
Science of measuring hearing acuity for variations in sound intensity and frequency
44
What does an audiometer do
The device used to produce sound of varying intensity and frequency
45
What is an audiogram
Where the hearing thresholds are listed to define if there is a hearing loss or not
46
What is a normal hearing threshold for an audiogram
0-20dB
47
What is central processing assessment
Assessment of hearing abilities rather than just tone detection
48
What are examples of central processing assessment
Sound localisation Filtered speech Speech in noise
49
What is tympanometry
Examination used to test the condition of the middle ear and mobility of the tympanic membrane and the conduction bones by creating variations of air pressure in the ear canal
50
What is A in tympanometry
Normal
51
What is C in tympanometry
Negative middle ear pressure
52
What can be the causes of B in tympanometry
Middle ear effusion Perforation of the tympanic membrane Eustachian (pharyngotympanic) tube dysfunction Occluded ear canal
53
What are otoacoustic emissions
Sounds produces by the normal cochlea, by the OHC as they expand and contract
54
When are OAEs performed
Newborn hearing screening and hearing loss monitoring
55
What is an auditory brainstem response
Electrical responses from the auditory pathway evoked by clicks (auditory evoked potential)
56
When are ABRs used
More commonly used in clinic and doesn't require attention from the patient - alterations in latency of waves can point to the location of a deficit. Commonly used in babies and children
57
What affects cortical potentials
Cortical potentials could be affected in neurological conditions or processing problems
58
What is conductive hearing loss
Problem is located in the outer or middle ear
59
What is sensorineural hearing loss
Problem is located in the inner ear or the auditory nerve
60
What is mixed hearing loss
Conduction and transduction of sound are affected therefore the problem stems from multiple parts of the ear
61
What do we see in an audiogram for conductive hearing loss
Bone conduction normal but air conduction shows hearing loss
62
What do we see in an audiogram for sensorineural hearing loss
bone and air conduction are both affected equally
63
What do we see in an audiogram for mixed hearing loss
Bone and air conduction are both affected but not equally
64
What are the classifications of hearing loss
Mild, moderate, severe, profound
65
What are causes of outer ear hearing loss
Wax | Foreign body
66
What are causes of middle ear hearing loss
Otitis | Otosclerosis
67
What are causes of inner ear hearing loss
Presbycusis | Ototoxicity
68
What are causes of nerve hearing loss
VIII nerve tumour
69
What are the 4 domains of hearing loss treatment
Underlying cause Hearing aid Cochlear implant Brainstem implant
70
What are hearing aids
Hearing aids amplify sound but do not replace any structure
71
What do we need to have a hearing aid
Functioning hair cells
72
What is a cochlear implant
Replaces the function of hair cells by receiving sound analysing it, transforming it into electrical signals and sending an electric impulse directly to the auditory nerve
73
What do we need to have a cochlear implant
Functional auditory nerve
74
What is a brainstem implant
When the auditory nerve is affected, electrical signal can be sent to a set of electrodes places directly into the brainstem
75
When is a brainstem implant advised
People with bilateral important auditory nerve damage - is a risky procedure